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Single abnormal gene structure of disorders, specifically the alpha (α) and beta (β) thalassemia recessive disorders are focused. From the NCBI website, the preferred DNA sequencing is downloaded. The objective is to study the structure of Single Abnormal Gene using modified Box counting principle and FFD-Fuzzy Fractal Dimension analysis. Initially the fractal dimension method is used and analyzed single abnormal gene structure with the help of box counting method where the grids are segmented into triangles. Further the analysis is enhanced through grid and triangular method of improved box counting methods named as Ruby Triangular dimension which is the novelty of the research. Comparison of Grid Dimension with Triangular Dimension based fractal and fuzzy fractal dimension in the severity of disease from its secondary structure of the disorder related genes structures are performed. Further the complexity of the Single Abnormal Gene structure evaluated to generate a unique Attractor for the prediction of the α-thalassemia and β-thalassemia disorder in earlier diagnosis, refer as bifurcation theory. The results shows that the triangular Ruby Dimension based improved box counting method facilitate quick with more exactitude. In grid method the size of the image should be 2n pixels and shrink to at most 2048 pixels, whereas the triangular pixels may be reduced to 23 times than grid method. Hence, this novel Fuzzy Fractal Ruby Triangular Dimension method shows better results and can be applied for image of higher dimensions with the same procedure. [ABSTRACT FROM AUTHOR]

Bacterial growing resistance to antibiotics poses a critical threat to global health. This study investigates, for the first time, the antibiofilm properties of Vicia ervilia agglutinin (VEA) from six different V. ervilia accessions against pathogenic bacteria, and the yeast Candida albicans. In the absence of antimicrobial properties, purified VEA significantly inhibited biofilm formation, both in Gram-positive and Gram-negative bacteria, but not in C. albicans. With an inhibitory concentration ranging from 100 to 500 µg/ml, the VEA antibiofilm activity was more relevant against the Gram-positive bacteria Streptococcus aureus and Staphylococcus epidermidis, whose biofilm was reduced up to 50% by VEA purified from accessions #5 and #36. VEA antibiofilm variability between accessions was observed, likely due to co-purified small molecules rather than differences in VEA protein sequences. In conclusion, VEA seed extracts from the accessions with the highest antibiofilm activity could represent a valid approach for the development of an effective antibiofilm agent. [ABSTRACT FROM AUTHOR]

Background: Radiomics can provide quantitative features from medical imaging that can be correlated with various biological features and diverse clinical endpoints. Delta radiomics, on the other hand, consists in the analysis of feature variation at different acquisition time points, usually before and after therapy. The aim of this study was to provide a systematic review of the different delta radiomics approaches. Methods: Eligible articles were searched in Embase, Pubmed, and ScienceDirect using a search string that included free text and/or Medical Subject Headings (MeSH) with 3 key search terms: 'radiomics,' 'texture,' and 'delta.' Studies were analyzed using QUADAS-2 and the RQS tool. Results: Forty-eight studies were finally included. The studies were divided into preclinical/methodological (5 studies, 10.4%); rectal cancer (6 studies, 12.5%); lung cancer (12 studies, 25%); sarcoma (5 studies, 10.4%); prostate cancer (3 studies, 6.3%), head and neck cancer (6 studies, 12.5%); gastrointestinal malignancies excluding rectum (7 studies, 14.6%) and other disease sites (4 studies, 8.3%). The median RQS of all studies was 25% (mean 21% ± 12%), with 13 studies (30.2%) achieving a quality score < 10% and 22 studies (51.2%) < 25%. Conclusions: Delta radiomics shows potential benefit for several clinical endpoints in oncology, such asdifferential diagnosis, prognosis and prediction of treatment response, evaluation of side effects. Nevertheless, the studies included in this systematic review suffer from the bias of overall low methodological rigor, so that the conclusions are currently heterogeneous, not robust and hardly replicable. Further research with prospective and multicenter studies is needed for the clinical validation of delta radiomics approaches. [ABSTRACT FROM AUTHOR]

This cross-sectional study aimed to assess the association between drugs and alcohol intake and sexual abuse in adolescents, otherwise defined as Drug Facilitated Sexual Assault (DFSA). We considered the survivors who accessed care at the Centre "Soccorso Violenza Sessuale" (SVS – Sexual Violence Relief Centre) in Turin (Italy), between May 2003 and May 2022. We found that 973 patients aged 13–24 among which 228 were victims of DFSA. Epidemiological and anamnestic aspects of the episode of sexual violence were examined, with a specific focus on investigating the alcohol and/or drug intake as reported by the victim, along with the results of the toxicological analysis. the study further accounts for the variations caused by the COVID-19 pandemic on DFSA-related accesses. Our findings show that 23% of adolescents accessing care at SVS were subjected to DFSA. Six out ten adolescents knew their aggressor, at times a partner (10%) oran acquaintance (43%). In 12% of cases violence was perpetrated by a group of people (12%). Almost 90% of young victims described alcohol consumption, while 37% reported drug use at the time of the assault. Alcohol taken alone or in combination with other substances was the most detected drug in our sample throughout the period considered. Given the large use of psychoactive substances among adolescents, it is imperative to implement harm reduction strategies alongside educational activities aimed at fostering awareness about consent. Health personnel should be trained to manage the needs of victims of DFSA clinically and forensically. [ABSTRACT FROM AUTHOR]

Bitter vetch (Vicia ervilia (L.) Willd.), one of the Near Eastern founder crops, is an annual cleistogamous legume domesticated during the Neolithic period. Originally used for human consumption, over time it was replaced by other pulses and downgraded to a fodder crop. When coupled with a small degree of cross hybridization, cleistogamy confers evolutive plasticity to the plant species. The aim of the present work consisted in setting up optimal conditions to overcome the existing cross hybridization barriers in V. ervilia. Genotypes of Turkish origin, characterized by an erect growth habit were crossed with Italian counterparts characterized by high seed production. A detailed cyto-histological analysis of flower development was undertaken to determine the optimal stage for emasculation and manual cross. Ninety-eight crosses were carried out and the hybrid nature of the putative F1 progenies was assessed by SSR (simple sequence repeat) DNA markers. Fifty-five seeds were obtained of which only five gave rise to hybrid plants. Among these, only three turned out to be fertile and two of which generated a consistent number of F2 seeds whose plants were assessed in greenhouse for seed production and plant growth habit. Most of the evaluated traits showed mean values of the F2 plants intermediate between the two initial parents, confirming that intraspecific hybridization is not only possible but also useful to exploit the diversity confined in different bitter vetch populations. [ABSTRACT FROM AUTHOR]

Background and objectives: Recent data have established non-inferiority of drug-coated balloons (DCB) compared to drug-eluting stents (DES) for treatment of small-vessel coronary artery disease. Since coronary vessels in women might have anatomical and pathophysiological particularities, the safety of the DCB strategy among women compared to men needs to be assessed in more detail. Methods: In BASKET-SMALL 2, patients with de novo lesions in coronary vessels < 3 mm and an indication for percutaneous coronary intervention were randomly allocated (1:1) to DCB vs. DES after successful lesion preparation. The primary objective of the randomized trial was to establish non-inferiority of DCB vs. DES regarding major adverse cardiac events (MACE; i.e., cardiac death, non-fatal myocardial infarction, and target vessel revascularization) after 12 months. The aim of the current sub-analysis is to evaluate whether the DCB strategy is equally safe among women and men after 12 and 36 months. Results: Among 758 randomized patients, 382 were assigned to DCB (23% women) and 376 to DES (30% women). In general, women were older, had more often diabetes mellitus and renal insufficiency, and presented more often with an acute coronary syndrome, whereas men were more often smokers, had multivessel disease and a previous history of acute myocardial infarction, and received a treatment with a statin. After 3 years, the primary clinical end point was not significantly different between groups (13% women vs. 16% men, HR 0.82; 95% CI 0.52−1.30; p = 0.40). There was no interaction between sex and coronary intervention strategy regarding MACE at 36 months (10% women vs. 16% men in DCB, 16% women vs. 15% men in DES; pinteraction = 0.31). Conclusion: In small native coronary artery disease, there was no statistically significant effect of sex on the difference between DCB and DES regarding MACE up to 36 months. Clinical trial registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01574534. [ABSTRACT FROM AUTHOR]

Purpose: To introduce percutaneous selective injection of autologous platelet-rich fibrin as a novel technique for persistent bile leakage repair and sharing the results of our preliminary experience. Materials and Methods: Seven patients (57.1% females; mean age 69.6 ± 8 years) with the evidence of persistent bile leak secondary to hepatobiliary surgery and ineffective treatment with percutaneous transhepatic biliary drainage were submitted to fibrin injection. Platelet-rich fibrin, a dense fibrin clot promoting tissue regeneration, was obtained from centrifuged patient's venous blood. Repeated percutaneous injections through a catheter tip placed in close proximity to the biliary defect were performed until complete obliteration at fistulography. Technical and clinical success were evaluated. Results: Bile leaks followed pancreaticoduodenectomy in five and major hepatectomy in two patients. Technical success defined as fibrin injection at BD site was achieved in all seven patients, and clinical success defined as a complete healing of the BD at fistulography was achieved in six patients. The median time to BD closure was 76.7 ± 40.5 days and the average procedure number was 3 ± 1 per patient. In one patient, defect persistance after four treatments required gelatin sponge injection. No major complications occurred. One case of post-procedural transitory hyperpirexia was registered. Conclusion: In persistent biliary defects, despite prolonged biliary drainage stay, percutaneous injection of autologous platelet-rich fibrin appears as a readily available and feasible emergent technique in promoting fistulous tracts obliteration still mantaining main ducts patency. [ABSTRACT FROM AUTHOR]

Spin waves are collective perturbations in the orientation of the magnetic moments in magnetically ordered materials. Their rich phenomenology is intrinsically three-dimensional; however, the three-dimensional imaging of spin waves has so far not been possible. Here, we image the three-dimensional dynamics of spin waves excited in a synthetic antiferromagnet, with nanoscale spatial resolution and sub-ns temporal resolution, using time-resolved magnetic laminography. In this way, we map the distribution of the spin-wave modes throughout the volume of the structure, revealing unexpected depth-dependent profiles originating from the interlayer dipolar interaction. We experimentally demonstrate the existence of complex three-dimensional interference patterns and analyze them via micromagnetic modelling. We find that these patterns are generated by the superposition of spin waves with non-uniform amplitude profiles, and that their features can be controlled by tuning the composition and structure of the magnetic system. Our results open unforeseen possibilities for the study and manipulation of complex spin-wave modes within nanostructures and magnonic devices. The techniques we typically employ to study spin-waves in magnetic materials, such as Brillouin Light Scattering, are two-dimensional. Spin waves, however, are manifestly three-dimensional. Here, Girardi et al. succeed in such three-dimensional imaging of spin waves in a synthetic antiferromagnet using Time-Resolved Soft X-ray Laminography. [ABSTRACT FROM AUTHOR]

Background: The GRACE risk score is generically recommended by guidelines for timing of invasive coronary angiography without stating which score should be used. The aim was to determine the diagnostic performance of different GRACE risk scores in comparison to the ESC 0/1 h-algorithm using high-sensitivity cardiac troponin (hs-cTn). Methods: Prospectively enrolled patients presenting with symptoms suggestive of myocardial infarction (MI) in two large studies testing biomarker diagnostic strategies were included. Five GRACE risk scores were calculated. The amount of risk reclassification and the theoretical impact on guideline-recommended timing of invasive coronary angiography was studied. Results: Overall, 8,618 patients were eligible for analyses. Comparing different GRACE risk scores, up to 63.8% of participants were reclassified into a different risk category. The proportion of MIs identified (i.e., sensitivity) dramatically differed between GRACE risk scores (range 23.8–66.5%) and was lower for any score than for the ESC 0/1 h-algorithm (78.1%). Supplementing the ESC 0/1 h-algorithm with a GRACE risk score slightly increased sensitivity (P < 0.001 for all scores). However, this increased the number of false positive results. Conclusion: The substantial amount of risk reclassification causes clinically meaningful differences in the proportion of patients meeting the recommended threshold for pursuing early invasive strategy according to the different GRACE scores. The single best test to detect MIs is the ESC 0/1 h-algorithm. Combining GRACE risk scoring with hs-cTn testing slightly increases the detection of MIs but also increases the number of patients with false positive results who would undergo potential unnecessarily early invasive coronary angiography. [ABSTRACT FROM AUTHOR]

Key message: A relationship between vertical acropetal inflorescences with protandrous flowers and bee pollination was hypothesized by Darwin back in 1877. Here we provide empirical evidence supporting this association across the angiosperms. Plant reproduction is not only determined by flower traits but also by the arrangement of flowers within inflorescences. Based on his observations of the orchid Spiranthes autumnalis, Darwin proposed in 1877 that bee-pollinated plants presenting protandrous flowers on vertical acropetal inflorescences, where proximal flowers open first, can exploit the stereotypical foraging behavior of their pollinators (i.e., upward movement through the inflorescence) to promote pollen exportation and reduce self-pollination. In these inflorescences, male-phase flowers lie spatially above female-phase flowers. To examine this untested hypothesis, we compiled literature information from 718 angiosperms species and evaluated the association between vertical acropetal inflorescences with protandrous flowers and bee pollination within a phylogenetic comparative framework. Results reveal that this type of inflorescence is indeed more common in species pollinated by bees. Moreover, this association does not seem to be weakened by the presence of alternative self-pollination avoidance mechanisms, like self-incompatibility, suggesting that this inflorescence type benefits mainly male rather than female fitness. Other inflorescence types placing male-phase flowers above female-phase flowers, e.g., vertical basipetal inflorescences with protogynous flowers, do not provide strong evidence of a differential association with pollination by bees. Female-biased nectar production in vertical acropetal inflorescences with protandrous flowers may reinforce the behavior of bees to fly upwards, rendering Darwin's configuration more adaptive than other inflorescence configurations. [ABSTRACT FROM AUTHOR]

Design closure and parameter optimisation are crucial in creating cutting-edge antennas. Antenna performance can be improved by fine-tuning preliminary designs created using theoretical considerations and rough dimension adjustment via supervised parameter sweeps. This paper introduces a frequency reconfigurable antenna design that can operate at 28/38 GHz frequencies to meet FCC and Ofcom standards for 5G applications and in the 18 GHz frequency band for K-band radar applications. A PIN diode is used in this design to configure multiple frequency bands. The antenna has a modified rectangular patch-like structure and two optimised plugins on either side. The study that is being presented focuses on maximising the parameters that are subject to optimisation, including length (Ls), width (Ws), strip line width (W1), and height (ht), where the antenna characteristic parameters such as directivity is tuned by a hybrid optimisation scheme called Elephant Clan Updated Grey Wolf Algorithm (ECU-GWA). Here, the performance of gain and directivity are optimally attained by considering parameters such as length, width, ground plane length, width, height, and feed offsets X and Y. The bandwidth of the proposed antenna at − 10 dB is 0.8 GHz, 1.94 GHz, and 7.92 GHz, respectively, at frequencies 18.5 GHz, 28.1 GHz, and 38.1 GHz. Also, according to the simulation results, in the 18 GHz, 28 GHz, and 38 GHz frequencies S11, the return loss is − 60.81 dB, − 56.31 dB, and − 14.19 dB, respectively. The proposed frequency reconfigurable antenna simulation results achieve gains of 4.41 dBi, 6.33 dBi, and 7.70 dBi at 18.5 GHz, 28.1 GHz, and 38.1 GHz, respectively. Also, a microstrip quarter-wave monopole antenna with an ellipsoidal-shaped complementary split-ring resonator-electromagnetic bandgap structure (ECSRR-EBG) structure has been designed based on a genetic algorithm having resonating at 2.9 GHz, 4.7 GHz, 6 GHz for WLAN applications. The gain of the suggested ECSRR metamaterial and EBG periodic structure, with and without the ECCSRR bow-tie antenna. This is done both in the lab and with numbers. The measured result shows that the ECSRR metamaterial boosts gain by 5.2 dBi at 5.9 GHz. At 5.57 GHz, the two-element MIMO antenna achieves its lowest ECC of 0.00081. [ABSTRACT FROM AUTHOR]

Personal identity and social identification processes can be challenging for adolescents belonging to an ethnic minority, who have to cope with the acculturation task of navigating several (and often conflictual) alternatives put forth by their cultural heritage community and destination society. Because identity and acculturation tasks are embedded in core domains of adolescents' life, this three-wave longitudinal study with ethnic minority adolescents (N = 244, 43.4% male; Mage = 14.9) examined how personal identity processes and social identifications are related to acculturation orientations in the education and friendship domains. Results of traditional cross-lagged models showed that, in the educational domain, adolescents who scored higher on cultural heritage maintenance compared to their peers, scored higher on commitment later on. In the friendship domain, stronger associations were found, such that adolescents who scored higher on cultural heritage maintenance compared to their peers, reported higher commitment and in-depth exploration later on, while those who scored higher on identification with friends reported over time also higher cultural heritage maintenance and destination culture adoption. Random-intercept crossed-lagged models indicated that, when adolescents reported above their own average on reconsideration of educational commitment, they reported increased cultural heritage maintenance later on. Furthermore, consistent associations (at baseline and over time) emerged. Overall, this study points to virtuous alliances between the fulfillment of tasks related to adolescents' identity development and acculturation. [ABSTRACT FROM AUTHOR]

Glucose is a universally available inexpensive biomarker, which is increased as part of the physiological stress response to acute myocardial infarction (AMI) and may therefore help in its early diagnosis. To test this hypothesis, glucose, high-sensitivity cardiac troponin (hs-cTn) T, and hs-cTnI were measured in consecutive patients presenting with acute chest discomfort to the emergency department (ED) and enrolled in a large international diagnostic study (NCT00470587). Two independent cardiologists centrally adjudicated the final diagnosis using all clinical data, including serial hs-cTnT measurements, cardiac imaging and clinical follow-up. The primary diagnostic endpoint was index non-ST-segment elevation MI (NSTEMI). Prognostic endpoints were all-cause death, and cardiovascular (CV) death or future AMI, all within 730-days. Among 5639 eligible patients, NSTEMI was the adjudicated final diagnosis in 1051 (18.6%) patients. Diagnostic accuracy quantified using the area under the receiver-operating characteristics curve (AUC) for the combination of glucose with hs-cTnT and glucose with hs-cTnI was very high, but not higher versus that of hs-cTn alone (glucose/hs-cTnT 0.930 [95% CI 0.922–0.937] versus hs-cTnT 0.929 [95% CI 0.922–0.937]; glucose/hs-cTnI 0.944 [95% CI 0.937–0.951] versus hs-cTnI 0.944 [95% CI 0.937–0.951]). In early-presenters, a dual-marker strategy (glucose < 7 mmol/L and hs-cTnT < 5/hs-cTnI < 4 ng/L) provided very high and comparable sensitivity to slightly lower hs-cTn concentrations (cTnT/I < 4/3 ng/L) alone, and possibly even higher efficacy. Glucose was an independent predictor of 730-days endpoints. Our results showed that a dual marker strategy of glucose and hs-cTn did not increase the diagnostic accuracy when used continuously. However, a cutoff approach combining glucose and hs-cTn may provide diagnostic utility for patients presenting ≤ 3 h after onset of symptoms, also providing important prognostic information. [ABSTRACT FROM AUTHOR]

Purpose: The study focuses on the evaluation of the new Node Reporting and Data System 1.0 (Node-rads) scoring accuracy in the assessment of metastatic lymph nodes (LN) in patients with colon carcinoma. Material and methods: From April 2021 to May 2022, retrospective chart reviews were performed on 67 preoperative CT (Computed Tomography) of patients undergoing excisional surgery for colon cancer at the Polyclinic of Bari, Italy. Primary endpoints were to assess lymph node size and configuration to express the likelihood of a metastatic site adopting the Node-rads score system, whose categories of risk are defined from 1 (very low) to 5 (very high). The nodal postsurgical histological evaluation was the gold standard. The relationship between Node-rads score, LN size, configuration criteria (texture, border and shape) and the presence of histological metastases was statistically evaluated. Results: All surgical specimens examined had correlation with Node-rads score. They were significantly more likely to present nodes micrometastasis those patients with (a) spherical LN shape (82.8%), (b) with lymph node necrosis (100%), (c) irregular borders (87%) and (d) the LN short axis more than 10 mm (61.9%). Conclusions: Our experience highlights how the Node-rads system proposes an intuitive and effective definition of criteria to standardize the lymph node radiological reports in colon cancer disease. Further studies are needed to streamline the classification of the nodal and peripheral LN in all the oncological imaging. [ABSTRACT FROM AUTHOR]

Background: Elevated pre-treatment baseline inflammation has been associated with cancer therapy-related cardiac dysfunction (CTRCD) in patients with breast cancer. Monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio and systemic immune-inflammation index (NLR × platelets) have emerged in clinical context as markers of disease-related inflammation. Objectives: To evaluate development of CTRCD according to pre-treatment blood inflammatory biomarkers in patients with breast cancer. Methods: Pilot cohort study including consecutive female patients ≥ 18 years with HER2-positive early breast cancer who consulted at the institution's breast oncology outpatient clinic between march/2019 and march/2022. CTRCD: absolute reduction in LVEF > 10% to below 53% (2D-echocardiogram). Survival analysis was performed using Kaplan–Meier curves, compared by the log-rank test, and discrimination ability was evaluated through AUC-ROC. Results: Forty-nine patients (53.3 ± 13.3 y) were included and followed-up for a median of 13.2 months. CTRCD was observed in 6 (12.2%) patients. Patients with high blood inflammatory biomarkers had lower CTRCD-free survival (P < 0.050 for all). MLR showed statistically significant AUC (0.802; P = 0.017). CTRCD was observed in 27.8% of patients with high MLR versus 3.2% with low MLR (P = 0.020); negative predictive value was 96.8% (95%CI 83.3–99.4%). Conclusion: In patients with breast cancer, elevated pre-treatment inflammatory markers were associated with increased risk of cardiotoxicity. Among these markers, MLR had good discriminatory performance and high negative predictive value. The incorporation of MLR might improve risk evaluation and selection of patients for follow-up during cancer therapy. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the association between oocyte area and fertilization rate, embryo usage, and preimplantation embryo development in order to establish if oocyte area can be a marker for optimal early embryo development. Methods: From 2017 to 2020, 378 couples with an indication for IVF (n = 124) or ICSI (n = 254) were included preconceptionally in the Rotterdam Periconception Cohort. Resulting oocytes (n = 2810) were fertilized and submitted to time-lapse embryo culture. Oocyte area was measured at the moment of fertilization (t0), pronuclear appearance (tPNa), and fading (tPNf). Fertilization rate, embryo usage and quality, and embryo morphokinetics from 2-cell stage to expanded blastocyst stage (t2-tEB) were used as outcome measures in association with oocyte area. Oocytes were termed "used" if they were fertilized and embryo development resulted in transfer or cryopreservation, and otherwise termed "discarded". Analyses were adjusted for relevant confounders. Results: Oocyte area decreased from t0 to tPNf after IVF and ICSI, and oocytes with larger area shrank faster (β − 12.6 µm2/h, 95%CI − 14.6; − 10.5, p < 0.001). Oocytes that resulted in a used embryo were larger at all time-points and reached tPNf faster than oocytes that fertilized but were discarded (oocyte area at tPNf in used 9864 ± 595 µm2 versus discarded 9679 ± 673 µm2, p < 0.001, tPNf in used 23.6 ± 3.2 h versus discarded 25.6 ± 5.9 h, p < 0.001). Larger oocytes had higher odds of being used (oocyte area at tPNf ORused 1.669, 95%CI 1.336; 2.085, p < 0.001), were associated with faster embryo development up to the morula stage (e.g., t9 β − 0.131 min, 95%CI − 0.237; − 0.025, p = 0.016) and higher ICM quality. Conclusion: Oocyte area is an informative marker for the preimplantation development of the embryo, as a larger oocyte area is associated with higher quality, faster developing embryos, and higher chance of being used. Identifying determinants associated with oocyte and embryo viability and quality could contribute to improved preconception care and subsequently healthy pregnancies. [ABSTRACT FROM AUTHOR]

Purpose: Metastatic ccRCC has peculiar tropism in the pancreas. We describe the characteristics and pathways of progression of patients with PM in a large multi-institutional consortium and compare them to patients with metastases from ccRCC at other sites. Methods: Detailed clinical and histopathological data were collected. To account for differences in baseline characteristics between the two groups, IPTW was used to compare the two groups in terms of PFS and OS. Results: Of the 182 patients, 33 (18%) had pancreatic, 94 (52%) pulmonary, 30 (16%) bone, 13 (7%) hepatic, and 12 (7%) brain metastases. Patients with PM had less aggressive ccRCC at baseline compared to those with progression at other sites in terms of tumour stage and grade. Median time from ccRCC surgery to PM was 8 (95%CI 5–10) vs. 1 year (95%CI 1–2) for progression to other sites (p < 0.001). Median IPTW-weighted time to second progression was 4.3 years (95%CI 2.4-not reached) for patients with PM vs 1.1 year (95%CI 0.8–2.3) for those with progression in other sites (p < 0.001). The most frequent second progression sites were pancreas (24%) and liver (15%) in patients with PM, while progression to the pancreas was rare (4%) in those with a different first progression site. Surgery alone (55%) or in combination with medical therapy (30%) was more frequent in the PM group than in other sites (p < 0.001). Median IPTW-OS time was longer for patients with PM [8.8 years (95%CI 6.5-not reached)] compared to those with first progression in other sites [2.8 years (95%CI 1.9–4.3), p < 0.001]. Conclusion: Pancreatic tropism is typical of ccRCC tumours with more indolent behaviour than those progressing to other sites. A long follow-up period is necessary to distinguish PM from ccRCC. [ABSTRACT FROM AUTHOR]

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Vulvovaginal candidiasis (VVC) is a most common infection caused by Candida species especially, Candida albicans. Herein, we report that phytoprotein based nano scaffolds mitigates the standard antifungal drug (fluconazole) resistant C. albicans. Copper sulfide nanoparticles (CuS NPs) and the phytolectin, jacalin functionalized copper sulfide nanoparticles (JCuS NPs) were evaluated against C. albicans cells. The minimum inhibitory concentration of JCuS NPs (0.1 µM) was tenfold lower than CuS NPs (1 µM). Kill curve assay showed that the NPs exhibit anticandidal activity in a time dependent manner. Standard antifungal drugs like Amphotericin B (AMP B) and Micafungin (MF) were evaluated individually against VVC causing Candida sp. and also combined with NPs to determine their synergistic effect. Interestingly, MF which belongs to echinocandins group of antifungals exhibhited synergistic activity and AMP B which belongs to polyenes group displayed an additive effect. Molecular level studies revealed that JCuS NPs in combination with micafungin inhibits the drug resistant efflux pump of C. albicans by down-regulating the efflux genes. The results revealed that JCuS NPs and its combination with standard drugs have a better anti-candidal effect, suggesting that the lectins has the potential to serve as a drug carrier by targeting the cell surface glycans of Candida. [ABSTRACT FROM AUTHOR]

The autonomous vehicle storage and retrieval system (AVS/RS) significantly improves the responsiveness and throughput of the traditional automated storage and retrieval system (AS/RS) in regard to handling unit loads. The AVS/RS consists of multiple tiers connected to an elevator system and is equipped with at least two autonomous vehicles, that is, a shuttle and satellite. Other necessary equipment are the lifts and input/output buffer areas. This paper aims to present and apply an original hybrid analytical-simulative model for the design of a deep-lane and multisatellite AVS-RS by evaluating and controlling the system performance. This AVS-RS is equipped with multiple free and non-free satellites for each tier. As an original contribution, this study reviews the literature on AVS/RS according to the introduction of multiple features categorized into five homogeneous groups: (1) rack configuration, (2) vehicle kinematics and configuration, (3) dispatching rules, (4) modeling approach, and (5) validation. Two of the most critical issues in existing research studies are the random arrival time of storage and retrieval transactions and the random storage policy. The proposed modeling approach is data-driven and based on realistic assumptions, filling the gap between the literature and real applications. This hybrid model is applied to a case study of the beverage industry according to a what-if comparative and competitive multiscenario analysis. This data-driven assessment supports the decision-making process on the number of satellites for each tier, while simultaneously controlling the service and waiting times, system throughput, and vehicle utilization. The analysis based on the maximum system throughput estimation demonstrates that introducing more than two satellites does not increase the productivity of the system. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to evaluate the feasibility and the safety of a novel, alternative method for bone tissue management in facial nerve decompression by a middle cranial fossa approach. Several applications of Piezosurgery technology have been described, and the technique has recently been extended to otologic surgery. The piezoelectric device is a bone dissector which, using micro-vibration, preserves the anatomic integrity of soft tissue thanks to a selective action on mineralized tissue. Methods: An anatomic dissection study was conducted on fresh-frozen adult cadaveric heads. Facial nerve decompression was performed by a middle cranial fossa approach in all specimens using the piezoelectric device under a surgical 3D exoscope visualization. After the procedures, the temporal bones were examined for evidence of any injury to the facial nerve or the cochleovestibular organs. Results: In all cases, it was possible to perform a safe dissection of the greater petrosal superficial nerve, the geniculate ganglion, and the labyrinthine tract of the facial nerve. No cases of semicircular canal, cochlea, or nerve damage were observed. All of the dissections were carried out with the ultrasonic device without the necessity to replace it with an otological drill. Conclusion: From this preliminary study, surgical decompression of the facial nerve via the middle cranial fossa approach using Piezosurgery seems to be a safe and feasible procedure. Further cadaveric training is recommended before intraoperative use, and a wider case series is required to make a comparison with conventional devices. [ABSTRACT FROM AUTHOR]

Nowadays, medical data classification plays an important role in healthcare informatics applications such as disease prediction, classification, etc. The recently developed machine learning and deep learning models are commonly employed for effective medical data classification, which can be applied for disease diagnosis. The existing techniques make few shortcomings in terms of computational complexity, higher-dimensional features, higher execution time, etc. To tackle these issues, this paper develops a new classification model with metaheuristic algorithm based optimal feature selection for Chronic Kidney Disease diagnosis. Initially, the data with missing values were evacuated in the pre-processing stage. Then, the best subset of features selected by a metaheuristic algorithm named Oppositional based FireFly Optimization algorithm, which helps in the prediction or classification of the disease more accurately. The incorporation of oppositional based learning concept helps to improve the convergence rate of FireFly algorithm. For classification, Deep Neural Network was proposed to diagnose the existence of CKD. The effectiveness of the proposed feature selection-based classifier was tested on the dataset as measures of sensitivity, specificity, and accuracy. The results concluded that the proposed algorithm achieved a high accuracy rate when compared to the algorithms of existing classifier models. [ABSTRACT FROM AUTHOR]

The "Hypogeum of the Garlands" is a sepulchral site, recently found in Grottaferrata (Lazio, Italy), dating back to the first-second century AD. Two sarcophagi were discovered inside, hosting the human remains of Aebutia Quarta, a rich Roman woman, and her son Carvilius Gemellus. While the body of Carvilius is exceptionally well-preserved, following its embalming and perfect sealing of the sarcophagus, in the case of Aebutia only the bones were preserved because of the sarcophagus's seal breaking down, although she was covered with perfectly preserved flower garlands. Embalming of the body was a rare ritual in the Imperial Roman times when corpses were more often cremated. The remains of Aebutia showed possible traces of heating. Burned bones from a third individual were discovered on the chamber's floor and preliminary anthropological survey showed that this individual was a male of 40–50 years old. Here, a combination of spectroscopic techniques, including non-destructive inelastic neutron scattering and Raman spectroscopy, and minimally destructive Fourier transform infrared spectroscopy, were applied to the analysis of these bone samples to give information about ancient Roman funerary practices. The temperature and burning conditions were thus determined, showing that Aebutia Quarta was exposed to mild temperatures (200 °C) only in the upper part of the body, while the third individual was likely cremated as its bones were exposed to temperatures up to 900 °C in quasi-anaerobic conditions. [ABSTRACT FROM AUTHOR]

Miscarriage is the spontaneous termination of a pregnancy before 24 weeks of gestation. We studied the genome of euploid miscarried embryos from mothers in the range of healthy adult individuals to understand genetic susceptibility to miscarriage not caused by chromosomal aneuploidies. We developed gp , a pipeline that we used to prioritize 439 unique variants in 399 genes, including genes known to be associated with miscarriages. Among the prioritized genes we found STAG2 coding for the cohesin complex subunit, for which inactivation in mouse is lethal, and TLE4 a target of Notch and Wnt, physically interacting with a region on chromosome 9 associated to miscarriages. [ABSTRACT FROM AUTHOR]

Cutaneous melanoma, Immunohistochemistry, Lymph node metastases, Nevi, Nicotinamide N-methyltransferase 1 Immunohistochemical expression of NNMT in dermal melanocytic nevi (a; the scale bar corresponds to 100 m), primary cutaneous melanomas (b; the scale bar corresponds to 50 m) and lymph node metastases from cutaneous melanoma (c; the scale bar corresponds to 30 m). Keywords: Cutaneous melanoma; Immunohistochemistry; Lymph node metastases; Nevi; Nicotinamide N-methyltransferase EN Cutaneous melanoma Immunohistochemistry Lymph node metastases Nevi Nicotinamide N-methyltransferase 480 482 3 01/06/23 20230101 NES 230101 Davide Sartini and Elisa Molinelli have contributed equally to this work. [Extracted from the article]

Background: Data on long-term actual survival in patients with surgically resected pancreatic ductal adenocarcinoma (PDAC) are limited. The aim of this study was to evaluate the actual 5-year disease-specific survival (DSS) and post-recurrence survival (PRS) in patients who underwent pancreatectomy for PDAC. Methods: Data from patients who underwent upfront surgical resection for PDAC between 2009 and 2014 were analyzed. Exclusion criteria included PDAC arising in the background of an intraductal papillary mucinous neoplasm and patients undergoing neoadjuvant therapy. All alive patients had a minimum follow-up of 60 months. Independent predictors of PRS, DSS, and survival > 5 years were searched. Results: Of the 176 patients included in this study, 48 (27%) were alive at 5 years, but only 20 (11%) had no recurrence. Median PRS was 12 months. In the 154 patients after disease recurrence, independent predictors of shorter PRS were total pancreatectomy, G3 tumors, early recurrence (< 12 months from surgery), and no treatment at recurrence. Median DSS was 36 months. Independent predictors of DSS were CA19-9 at diagnosis > 200 U/mL, total pancreatectomy, N + status, G3 tumors and perineural invasion. Only the absence of perineural invasion was a favorable independent predictor of survival > 5 years. Conclusion: More than one-quarter of patients who underwent upfront surgery for PDAC were alive after 5 years, although only 11% of the initial cohort were cancer-free. Long-term survival can also be achieved in tumors with more favorable biology in an upfront setting followed by adjuvant chemotherapy. [ABSTRACT FROM AUTHOR]

Globally, the occurrence of biofilm associated infection has become an alarming menace to the medical fraternity because the thick exopolysaccharide layer encasing the biofilms makes the biofilm producing pathogens inherently resistant to antibiotics. Candida albicans, the most common pathogen among Candida spp. is the causative agent for superficial and invasive candidiasis. The morphological phase switching from yeast to hyphal form is one of the virulent traits of C. albicans critical for its pathogenicity. Owing to the emergence of antifungal resistance among this opportunistic fungus, there is a dire need for improvised alternative antifungal agents. In the present study, we have evaluated a biosurfactant from a marine bacterium for its biofilm disruption ability against C. albicans. This biosurfactant had the potential to disrupt biofilms as well as to inhibit the morphological transition from yeast to hyphae. In addition, this biosurfactant showed enhance disruption of mixed species biofilms of C. albicans and Staphylococcus epidermidis when combined with DNase isolated from marine bacteria. From the results obtained, it is evident that the biosurfactant could act as a potential antibiofilm agent against drug resistant C. albicans strains. [ABSTRACT FROM AUTHOR]

Preoperative characterization of parotid gland tumors using imaging or cytological examination (fine-needle aspiration cytology) has a strong clinical and therapeutic impact, but it is often difficult due to the tumors' histological heterogeneity. The recent introduction of contrast-enhanced ultrasound (CEUS) and elastography, in the context of multiparametric ultrasound evaluation, contributed to improving the preoperative diagnosis of many diseases affecting the liver, breast, and thyroid, as well as other organs. However, limited evidence is available on the use and the diagnostic power of these techniques in parotid gland neoplasms. In this paper, we present a case of a parotid lesion that highlights the importance of a complete workup using multiparametric ultrasound evaluation, including CEUS and elastography, to identify malignant tumors of the parotid gland. [ABSTRACT FROM AUTHOR]

Introduction: The pneumatization of the different regions of the temporal bone is strictly related to the age and the degree of development of the mastoid and the middle ear. Petrous apex pneumatization is the last step of the development of the petrous bone system. The subcochlear canaliculus is an anatomical cavity, originating in the space between the fustis and the finiculus, and connecting the round window area to the petrous apex. The aim of the present article is analyzing the trend of development of the subcochlear canaliculus pneumatization, classified through CT scan examination, in different age subgroups. Materials and methods: We conducted a retrospective review of patients who underwent temporal bone CT scans between 2014 and 2019. Pediatric and adult patients were included and divided into different age subgroups. The subcochlear canaliculus was examined through coronal view scans at the level of the round window niche and classified into 3 different groups (A, B and C) according to the degree of pneumatization. Results: A total of 270 Petrous bone CT scans was analyzed. The percentage of type A subcochlear canaliculus was significantly higher in the pediatric population if compared to the adult population (p = 0.001326). As far as type B subcochlear canaliculus is concerned, the difference between children and adults was not statistically significant (p = 0.2378). On the other hand, type C subcochlear canaliculus was predominant in the adult population (p = 0.000256). Conclusions: There is a constant increase in pneumatization of the subcochlear canaliculus from 0 to 19 years and then a progressive decrease. This discovery has relevant surgical implications and has to be borne in mind in particular for cholesteatoma surgery and cochlear implantation surgery in the age groups in which the subcochlear canaliculus is highly pneumatized. [ABSTRACT FROM AUTHOR]

The interest of extra-criteria antiphospholipid antibodies is growing, especially in patients negative for conventional antibodies. In this study we aimed to assess the clinical utility of anti-phosphatidyl-serine/prothrombin antibodies (aPS/PT) testing in patients negative for Beta2-Glycoprotein 1(β2GPI)-dependent tests, for identifying antiphospholipid syndrome (APS) patients that developed cerebrovascular events (CVE). When screening APS patients attending our center, out of 119 aPS/PT IgG/IgM-positive patients, thus patients negative for aβ2GPI and aCL, 42 patients (35%) tested negative for β2GPI-dependent tests and were tested with thrombin generation assay (TGA). Ten patients (24%), with isolated aPS/PT IgG/IgM, had a history of CVE. Lupus anticoagulant (LA)-positive test was more frequently observed in patients with CVE (8/22 vs. 2/20; p = 0.045). Out of the 10 patients who experienced CVE, 3 patients were aPS/PT IgG positive (all LA positive), and 8 patients were aPS/PT IgM positive (6/8 LA positive). One patient was positive for both aPS/PT IgG and IgM. LA-positive patients had only high titers of aPS/PT IgG/IgM, all of them being ≥ 80 U/ml, while the 2 LA-negative patients were aPS/PT IgM positive with medium titers [40–60 U/ml]. LA-positive patients had significantly altered TGA profile when compared to those who were LA negative, considering all TGA parameters. LA-positive patients had significantly higher tLag (8.4 ± 3.3 min vs. 6.6 ± 1.8 min; p = 0.046), higher tPeak (14 ± 4.3 min vs. 11 ± 2.7 min; p = 0.015) and lower Peak (207 ± 152 nM vs. 356.3 ± 104.7 nM; p < 0.001) and lower AUC (2109.7 ± 1006.9 nM vs. 2772.5 ± 776.8 nM; p = 0.033). The use of aPS/PT might be of help in identifying patients with CVE and APS, as also confirmed by TGA testing. [ABSTRACT FROM AUTHOR]

Electric fishing is an illegal hunting method, unfortunately widely used by poachers to paralyze fish and to catch many animals in a short time. In Italy, it is authorized only for scientific and conservative purposes. Between 2014 and 2018, the Ferrara section of the Experimental Zooprophylactic Institute of Lombardy and Emilia Romagna, Italy, received nine cases of potentially illegal electric fishing in Po river and its tributary rivers. Necropsies were performed following standard protocols and samples of different tissues were collected and examined using histochemical and immunohistochemical techniques. Gross lesions frequently observed were circulatory alteration phenomena (i.e. multi-organ hyperemia, hemorrhages and congestion, hemopericardium), also found histologically, in addition to multifocal degenerative and necrotic muscular processes that could be attributed to injuries from electric current, as already reported in literature. Immunohistochemical investigations confirmed degenerative and necrotic lesions with myoglobin depletion and a corresponding fibrinogen accumulation. Myoglobin globules were also detected in the renal parenchyma, as consequent of rhabdomyolysis. The results of this study allowed to correlate electric fishing to gross, histologic and immunohistochemical lesions, which together constitute a pathognomonic picture to be considered a reference standard in this type of illegal controversy. [ABSTRACT FROM AUTHOR]

Endometriosis is an estrogen-dependent chronic disease affecting about 10% of reproductive-age women with symptoms like pelvic pain and infertility. Pathologically, it is defined by the presence of endometrial tissue outside the uterine cavity responsible for a chronic inflammatory process. For decades the diagnosis of endometriosis was based on surgical exploration and biopsy of pelvic lesions. However, laparoscopy is not a risk-free procedure with possible false negative diagnosis due to an underestimate of retroperitoneal structures such as ureters and nerves. For these reasons nowadays, the diagnosis of endometriosis is based on a noninvasive approach where clinical history, response to therapy and imaging play a fundamental role. Trans-vaginal ultrasound and magnetic resonance imaging are suitable for recognizing most of endometriotic lesions; nevertheless, their accuracy is strictly determined by operators' experience and imaging technique. This review paper aims to make radiologists aware of the diagnostic possibilities of pelvic MRI and familial with the MR acquisition protocols and image interpretation for women with endometriosis. [ABSTRACT FROM AUTHOR]

Developmental literature highlights that cognitive, moral, and affective development proceeds from concrete operations to more abstract ones. However, it is not known whether this fundamental developmental trajectory also characterizes the development of social identification (i.e., the feelings of belonging, affiliation, and correctness to a group, coupled with the sense of commonality with fellow ingroup members). This longitudinal study aimed (a) to unfold the association between identifications with two proximal groups (i.e., classmates and friends) and identification with humanity, and (b) to examine how these identifications with close and abstract groups affect adolescents' social well-being (i.e., an indicator of youth adaptation in their societies and communities). Participants were 304 adolescents (61.84% female, Mage = 17.49) involved in a three-wave longitudinal study. Identification with proximal social groups (especially classmates) was positively associated with identification with humanity, and identifications with both proximal and abstract groups were related to social well-being over time. Moreover, identification with humanity and identification with friends mediated the positive longitudinal effects of identification with classmates on social well-being. The implications of these findings for adolescents' social inclusivity and adjustment are discussed. [ABSTRACT FROM AUTHOR]

In this contribution, we investigated the role of plants in the prehistoric community of Casale del Dolce (Anagni, FR, central Italy), through microparticles recovered from dental calculus. The finding of a great amount of pollen types, even in form of compact lumps, could indicate use of natural substances, such as honeybee products and/or conifer resins. This plant-microremain record also suggested environmental implications relative to the Neolithic and Chalcolithic period. Additionally, the stability of the tartar microenvironment had preserved starches and other microparticles, such as one epidermal trichome, a sporangium, and fragments of plant tissue, rarely detected in ancient dental calculus. The detection of secondary metabolites in the ancient matrix confirmed the familiarity of this community with plant resources. All these data supply various interesting food for thought and expand the knowledge about the potential of dental calculus in archaeological and archaeobotanical fields with a special focus on palaeoecology. [ABSTRACT FROM AUTHOR]

Background: Radium-223 prolongs overall survival (OS) and delays time to the first symptomatic skeletal events in patients with symptomatic metastatic castration-resistant prostate cancer (mCRPC). There is a lack of evidence on the safety and efficacy of Radium-223 treatment in the very elderly population. Aims: Aim of this multicentre study is to analyze mCRPC patients treated with Radium-223 in terms of OS and to assess whether there are differences between young and elderly, as well as to verify efficacy and safety in patients ≥ 75 years of age. Methods: 430 mCRPC patients of six Italian Centres were analyzed in this multicenter retrospective study. At baseline and after each cycle were collected clinical and diagnostic patients' parameters. The whole cohort was divided into two groups based on the age of the patients (< 75 years old and ≥ 75 years old). Results: 47% of the patients were < 75 years old and 53% were ≥ 75 years old. The primary outcome, OS, does not show significant differences between the two subgroups if other basal parameters are considered. Considering clinical covariates in univariate models (p < 0.05) several clinical aspects have an impact on OS, except for age (p = 0.072). Age continues to have no significant impact on the OS (p = 0.274) even in multivariate models in the two groups. The toxic effects are similar in the two groups. Conclusions: Radium-223 prolongs survival in both younger and older patients at the same baseline condition and is a good option in the symptomatic mCRPC setting compared to other agents. [ABSTRACT FROM AUTHOR]

Takayasu arteritis (TAK) is a rare granulomatous vasculitis of unknown etiology that mainly affects the aorta and its major branches. The aim is to describe the clinical features, diagnostic procedures, pathogenesis, and management of TAK in a longitudinal cohort of patients recruited within a single region of southern Italy. The cohort included 43 patients who were diagnosed with TAK and followed up according to a standard protocol, in a collaboration between four university tertiary referral centers and a regional hospital. Clinical and imaging classification criteria were those established by the American College of Rheumatology. Thirty-five patients (81.4%) were female, and the mean age at disease onset was 32.6 (range 16–54) years. Angiographic assessment of the vascular involvement allowed disease classification in five different types. Clinical features ranged from constitutional symptoms in the early inflammatory stage of the disease to cardiovascular ischemic symptoms in the late, chronic stage. Noninvasive imaging techniques were employed to assess the extent and severity of the arterial wall damage and to monitor the clinical course and response to therapy. Medical treatment, based on pathogenetic insights into the roles of humoral and cell-mediated immune mechanisms, included glucocorticoids mostly combined with steroid-sparing immunosuppressive agents and, in patients with relapsing/refractory disease, biologic drugs. Significant clinical and angiographic differences have been detected in TAK patients from different geographic areas. Patients with life-threatening cardiovascular and neurologic manifestations as well as sight-threatening ophthalmologic signs and symptoms should be promptly diagnosed, properly treated, and closely followed up to avoid potentially severe consequences. [ABSTRACT FROM AUTHOR]

Sutures are widely used materials for closing the surgical wounds, and being an inert material, sutures are often colonized with drug-resistant polymicrobial biofilms. Surgical site infection (SSI) is a hospital-acquired infection caused by bacteria and fungi specifically in the sutured sites. Although most of the currently available sutures possess antibacterial property, their ability to prevent biofilm colonization by polymicrobial communities is underexplored. So, the present study shows that extracted chitosan (EC) from crab shells prevented the adherence of Staphylococcus epidermidis and Candida albicans, the predominant members that exist as mixed species at the site of SSI. In comparison with a commercial chitosan, EC showed profound inhibition of slime formation and mixed species biofilm inhibition. Intriguingly, EC-coated sutures could inhibit the growth of both bacterial and fungal pathogens when comparing with a commercial triclosan-coated suture which was active only against the bacterial pathogen. Scanning electron microscopy results revealed inhibition of C. albicans hyphal formation by the EC-coated sutures that is a crucial virulence factor responsible for tissue invasiveness. Collectively, the results of the present study showed that EC from crab shells (discarded material as a recalcitrant biowaste) could be used as an alternative to combat drug-resistant biofilms which are the prime cause for SSIs. [ABSTRACT FROM AUTHOR]

The M7.8 Nepal earthquake on 25 April 2015 and its aftershocks triggered thousands of landslides. Understanding correlations between the landslide occurrences and landslide conditioning factors is essential to generate a landslide susceptibility map. This study considers the two most reliable inventory data: landslide inventory 1 (LI-1) and landslide inventory 2 (LI-2). The LI-1 contains 1,352 landslide polygons, and the LI-2 contains 4,000 landslide points. The centroid locations of LI-1 were also considered as additional point inventory data for the statistical analyses. The landslide area percentage and landslide number density are computed for important factors such as slope angle, slope roughness, aspect, peak ground acceleration (PGA), distance to epicenter, distance to rivers and roads, Normalized Difference Vegetation Index (NDVI), land use and land cover, and mean annual precipitation. The cumulative percentage curves and the areas under the curve (AUC) are also compared for all the considered factors. PGAs of the main shock and two major aftershocks, distance to epicenter, slope angle, distance to river, and NDVI have relatively stronger correlations with the landslide occurrence than other factors. It is found that the LI-1 polygons have weaker correlations with the factors than LI-1 points and LI-2 points do because the LI-1 does not distinguish debris from scarps. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 is a rapidly evolving pandemic causing great morbimortality. Medical therapy with hydroxicloroquine, azitromycin and protease inhibitors is being empirically used, with reported data of QTc interval prolongation. Our aim is to assess QT interval behaviour in a not critically ill and not monitored cohort of patients. We evaluated admitted and ambulatory patients with COVID-19 patients with 12 lead electrocardiogram at 48 h after treatment initiation. Other clinical and analytical variables were collected. Statistical analysis was performed to assess the magnitude of the QT interval prolongation under treatment and to identify clinical, analytical and electrocardiographic risk markers of QT prolongation independent predictors. We included 219 patients (mean age of 63.6 ± 17.4 years, 48.9% were women and 16.4% were outpatients. The median baseline QTc was 416 ms (IQR 404–433), and after treatment QTc was prolonged to 423 ms (405–438) (P < 0.001), with an average increase of 1.8%. Most of the patients presented a normal QTc under treatment, with only 31 cases (14.1%) showing a QTc interval > 460 ms, and just one case with QTc > 500 ms. Advanced age, longer QTc basal at the basal ECG and lower potassium levels were independent predictors of QTc interval prolongation. Ambulatory and not critically ill patients with COVID-19 treated with hydroxychloroquine, azithromycin and/or antiretrovirals develop a significant, but not relevant, QT interval prolongation. [ABSTRACT FROM AUTHOR]

Ralstoniasolanacearum is a soil-borne plant pathogen which causes wilt disease in economically important crops of the Solanaceae family in tropical and temperate regions. As biofilm formation is the major virulence factor in R.solanacearum, research inputs are necessary to identify natural biofilm inhibitors to mitigate virulence of this bacterium. Hence in the present work, the anti-biofilm potential of phytochemical compound gallic acid (GA) isolated from an agricultural byproduct (cashewnut shell) was investigated. Initially the Minimum inhibitory concentration (MIC) of crude extracts of cashewnut shell and coconut shell against R.solanacearum were investigated. The MIC of both the extracts were 400 µg/ml and their sub-MIC (200 µg/ml) inhibited biofilms in the range of 62–70% and 49–57%, respectively. As the cashewnut shell extract have higher biofilm inhibitory effect compared to coconut shell extract, we proceeded our further study by isolating the major compound GA from cashewnut shell by acid hydrolysate method. The sub-MIC of crude cashewnut shell extract inhibited 85% of young biofilms. The MIC of GA were observed at 3 mg/ml and sub-MIC (1.5 mg/ml) was found to eradicate 85% of mature biofilms which was confirmed by standard crystal violet assay and the biofilm reduction was further visualized under light microscopy and scanning electron microscopic images. Toxicity of GA was evaluated against R.solanacearum through XTT cell viability assay and found no antibacterial effect at sub-MIC. Additionally, it is confirmed with growth curve and time kill assays. Swimming and twitching motility were considered as an important virulence factors to invade plants and to block the xylem vessels. Therefore, sub-MIC of GA was found to inhibit both swimming and twitching motility of about 93% and 63% respectively. Anti-biofilm efficacy of GA was also worked well with tomato plant model where remarkable biofilm inhibition was found on treatment with GA before and after 24 h of infection with R.solanacearum. Hence GA will be an alternative, cheap source which is eco-friendly as well as novel source for the treatment of R.solanacearum biofilms and to prevent wilt disease in important crops. [ABSTRACT FROM AUTHOR]